Abstract
Women decline blood products in pregnancy for religious reasons or because of concerns regarding their safety. Mortality is significantly increased in pregnant women who decline blood products. Antenatal counselling and planning must involve a senior multidisciplinary team. Considerable efforts are needed to optimise pre‐delivery haemoglobin and identify risk factors for haemorrhage. Intrapartum techniques to avoid blood transfusion include cell salvage and early recourse to definitive surgical management in the event of massive obstetric haemorrhage. Learning objectives: To understand the reasons why women decline blood and blood products in pregnancy and how this impacts on their health. To understand the law relating to women who decline treatment in pregnancy. To learn how to make the most of antenatal care opportunities. To be able to plan labour and postpartum care. To review the differences in managing massive obstetric haemorrhage between women who decline blood products and those who do not. Ethical issues: Women's autonomy can be supported with accurate information and empathic counselling. Given real concerns regarding the safety and availability of donor blood transfusion, should blood conservation techniques in obstetrics be applied to all women? Please cite this article as: Currie J, Hogg M, Patel N, Madgwick K, Yoong W. Management of women who decline blood and blood products in pregnancy. The Obstetrician & Gynaecologist 2010;12:13–20.
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